Health Reform WK-EDGE Iowa takes another bite at managed care oversight
Monday, April 30, 2018

Iowa takes another bite at managed care oversight

By Wolters Kluwer Editorial Staff

The Iowa House again unanimously approved legislation providing oversight of Medicaid managed care to deal with reservations raised in previously passed legislation. The House earlier passed similar legislation on a 97-0 vote, but failed to meet a deadline required by the Iowa Senate. The new legislation, House File 2483, passed on a 95-0 vote.

The bill addresses the timeliness of Medicaid payments, denial reasoning, credentialing, prior authorizations, appeals, level of care determinations and a small claims audit. One of the changes approved would decrease guaranteed court-order treatment time from five days to three before medical necessity criteria is applied. As a result, there would be a 40 percent decrease in the cost to Iowa Medicaid, but still allow for treatment over a long weekend.

An analysis by the Iowa Legislative Services Agency after passage of the first attempt noted that the bill’s cost would be $4.7 million. However, lawmakers were able to find ways to reduce the price tag to $1.55 million in the new version.

Legislation: StateLegislationNews AccessNews AgencyNews ManagedCareNews MedicaidNews

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